Isolation and infusion of donor CD34+ bone marrow cells in cadaver kidney transplantation.
BACKGROUND
Infusion of donor bone marrow cells induces tolerance in allograft models. CD34+ stem cells present in human bone marrow could be endowed with tolerogenic properties.


METHODS
CD34+ stem cells were isolated from bone marrow extracted from vertebral bodies of cadaveric donors. Donor CD34+ cells (0.6-3.7 x 10(6)/kg) were infused during surgery in 10 kidney transplant recipients receiving OKT3 as induction therapy. Chimerism was investigated using nested PCR for donor-specific HLA alleles.


RESULTS
The infusion of CD34+ stem cells was perfectly tolerated. Five patients remained free of acute rejection at follow-up, 47-325 days post-operatively. The five other patients underwent a single episode of corticosensitive acute rejection. Long-term chimerism was not induced in the seven patients investigated for the persistence of donor DNA.


CONCLUSIONS
Infusion of donor CD34+ stem cells in kidney transplantation is safe. The clinical usefulness of the procedure remains to be established.
De Pauw
L
L
Department of Nephrology-Dialysis-Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
Abramowicz
D
D
Donckier
V
V
Kornreich
A
A
Destrée
M
M
Demoor
F
F
Andrien
M
M
Lambermont
M
M
Goldman
M
M
D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis*; D002102:Cadaver; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016030:Kidney Transplantation; D008875:Middle Aged
D018952:Antigens, CD34